How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $144.54 Median $3,090.30 Typical High $8,912.51 | Facility | None | $144.54 | $3,090.30 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $245.47 | Professional | None | $112.20 | $165.96 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $363.08 | Professional | None | $131.83 | $199.53 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $1,659.59 | Facility | None | $134.90 | $234.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $245.47 | Professional | None | $114.82 | $158.49 | $245.47 |
Denver HMP Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $234.42 | Facility | None | $112.20 | $165.96 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $281.84 | Professional | None | $109.65 | $177.83 | $281.84 |
Select Health Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $346.74 | Facility | None | $165.96 | $177.83 | $346.74 |
Select Health Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $165.96 | Professional | None | $70.79 | $125.89 | $165.96 |
United Setting Facility Modifier None Typical Low $489.78 Median $1,122.02 Typical High $2,884.03 | Facility | None | $489.78 | $1,122.02 | $2,884.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $288.40 | Professional | None | $120.23 | $173.78 | $288.40 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $22.39 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $104.71 Typical High $123.03 | Professional | 54 · Surgery only | $85.11 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $24.55 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $97.72 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $79.43 | $97.72 | $114.82 |
Where Colorado sits
The same service costs 3.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 13th of 51
$200
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.